Analysis on the Hospitalization Expenses of Patients with Hysteromyoma Based on CHS-DRG Grouping
Objectives To analyze the grouping of uterine fibroid disease CHS-DRG and the influencing factors of hospitalization expenses,providing reference for reasonable cost control and exploring the development of CHS-DRG payment.Methods Screening the medical records and settlement data of 698 hospitalized patients with uterine fibroids from March 15th to September 15th,2022,using descriptive statistical analysis of CHS-DRG enrollment,compensation,and hospitalization expense structure,coefficient of variation(CV)to measure homogeneity within the group,and single factor analysis and multiple linear regression to analyze factors affecting hospitalization expenses.Results The average hospitalization expense for cases of uterine fibroids was 16837.67 yuan,with surgery,consumables,and medication accounting for 77％of the total cost.Six groups were included in the CHS-DRG settlement,with coefficients of variation all less than 0.6.The ND 19,NE 19,and NF 19 groups were in a loss state.Univariate analysis found that patient age(P=0.005),length of hospitalization stay(P=0.000),surgical method(P=0.000),number of surgeries(P=0.000),location of fibroids(P=0.000),and CHS-DRG grouping(P=0.000)had a statistically significant impact on hospitalization costs.Further analysis using multiple linear regression showed that the length of hospital stay(β=0.268,P=0.000),number of surgeries(β=0.297,P=0.000)and surgical method are the main influencing factors of hospitalization costs.The hospitalization cost increases with the number of surgeries and length of stay.For each additional length of stay,the hospitalization cost increases by 826.321 yuan;For every increase in the number of surgeries,the hospitalization cost increases by 1000.540 yuan.The cost of laparoscopic group,open group,and uterine artery embolization group was significantly higher than that of hysteroscopy group,with a total cost of 7492.26 yuan,respectively(β=0.583,P=0.000),8040.71 yuan(β=0.455,P=0.000)and 14985.55 yuan(β=0.208,P=0.000).Conclusions The CHS-DRG grouping for uterine fibroid disease was relatively reasonable,but there was still insufficient compensation.The length of hospitalization stay,number of surgeries,and surgical methods mainly affected hospitalization expenses.Hospitals should strengthen clinical pathway management,establish disease diagnosis and treatment standards,and shorten hospitalization time;Promote disease expense management,optimize expense structure,and compress expense space.Through measures such as DRG grouping rules and medical record quality training,we aimed to improve the accuracy of enrollment and explore more suitable CHS-DRG grouping schemes for clinical cases in practice.
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